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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 134 Research Studies DisplayedBowling CB, Bromfield SG, Colantonio LD
Association of reduced eGFR and albuminuria with serious fall injuries among older adults.
The researchers studied adverse outcomes in patients on dialysis as a result of falls. They found that among participants with CKD, cumulative 1-year mortality rates among patients with a serious fall and age-matched controls were 21.0% and 5.5%, respectively, and noted that elevated ACR but not lower eGFR was associated with serious fall injuries. They concluded that evaluation for fall risk factors and fall prevention strategies should be considered for older adults with elevated ACR.
AHRQ-funded; HS023009.
Citation: Bowling CB, Bromfield SG, Colantonio LD .
Association of reduced eGFR and albuminuria with serious fall injuries among older adults.
Clin J Am Soc Nephrol 2016 Jul 7;11(7):1236-43. doi: 10.2215/cjn.11111015.
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Keywords: Elderly, Falls, Patient-Centered Outcomes Research, Kidney Disease and Health, Injuries and Wounds
Shelley DR, Ogedegbe G, Anane S
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
The long-term goal of the HealthyHearts NYC trial is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines in primary care practices. The authors hypothesized that practice facilitation will result in superior clinical outcomes compared to usual care and that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with patient-centered medical homes and the chronic care model.
AHRQ-funded; HS023922.
Citation: Shelley DR, Ogedegbe G, Anane S .
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
Implement Sci 2016 Jul 4;11(1):88. doi: 10.1186/s13012-016-0450-2.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Primary Care
Luo Z, Chen Q, Annis AM
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
Two contrasting strategies of chronic care management include provider-delivered care management (PDCM) and health plan-delivered care management (HPDCM). The researchers aimed to compare the effectiveness of PDCM vs. HPDCM on improving clinical outcomes for patients with chronic diseases. They found that in a commercially insured population, neither PDCM nor HPDCM resulted in substantial improvement in patients' clinical indicators in the first year.
AHRQ-funded; HS020108.
Citation: Luo Z, Chen Q, Annis AM .
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
J Gen Intern Med 2016 Jul;31(7):762-70. doi: 10.1007/s11606-016-3617-2.
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Keywords: Chronic Conditions, Care Management, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Comparative Effectiveness, Patient-Centered Outcomes Research, Health Insurance
Belforti RK, Lagu T, Haessler S
Association between initial route of fluoroquinolone administration and outcomes in patients hospitalized for community-acquired pneumonia.
The objective of this study was to compare outcomes of hospitalized patients with community-acquired pneumonia receiving intravenous vs oral respiratory fluoroquinolones. The authors concluded that there was no association between initial route of administration and outcomes.
AHRQ-funded; HS018723.
Citation: Belforti RK, Lagu T, Haessler S .
Association between initial route of fluoroquinolone administration and outcomes in patients hospitalized for community-acquired pneumonia.
Clin Infect Dis 2016 Jul 1;63(1):1-9. doi: 10.1093/cid/ciw209.
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Keywords: Community-Acquired Infections, Pneumonia, Comparative Effectiveness, Patient-Centered Outcomes Research, Antibiotics
Wang SY, Hsu SH, Gross CP
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
The purpose of this paper is to examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission. The researchers found that most cancer survivors did not experience poorer mental health, but that survivors of prostate or cervical cancer had lower mental component summary scores after 10 years of diagnosis. They concluded that the level of HRQOL among cancer survivors depends on time since cancer diagnosis and cancer type.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Gross CP .
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
Value Health 2016 Jul-Aug;19(5):631-8. doi: 10.1016/j.jval.2016.02.010.
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Keywords: Cancer, Diagnostic Safety and Quality, Health Status, Patient-Centered Outcomes Research, Quality of Life
Sawinski D, Trofe-Clark J, Leas B
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
The researchers evaluated 92 comparisons from 88 randomized controlled trials and found moderate- to high-strength evidence suggesting that minimization strategies result in better clinical outcomes compared with standard-dose regimens and moderate-strength evidence indicating that conversion to a mammalian target of rapamycin inhibitor or belatacept was associated with improved renal function but increased rejection risk.
AHRQ-funded; 290201200011I.
Citation: Sawinski D, Trofe-Clark J, Leas B .
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
Am J Transplant 2016 Jul;16(7):2117-38. doi: 10.1111/ajt.13710.
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Keywords: Transplantation, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Medication
Cato KD, Bockting W, Larson E
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
Using the Belmont Report's principles of respect for persons, beneficence, and justice as a framework, the authors examined the ethical issues posed by electronic phenotyping. Ethical issues identified include the ability of the patient to consent for the use of their information, the ability to suppress pediatric information, and ensuring that the potential benefits justify the risks of harm to patients.
AHRQ-funded; HS022961.
Citation: Cato KD, Bockting W, Larson E .
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
J Empir Res Hum Res Ethics 2016 Jul;11(3):214-9. doi: 10.1177/1556264616661611.
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Keywords: Clinician-Patient Communication, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries, Research Methodologies
Lyu PF, Hockenberry JM, Gaydos LM
Impact of a sequential intervention on albumin utilization in critical care.
The authors evaluated the effect of a sequential multifaceted intervention on decreasing albumin use in the intensive care unit. They found that a sequential intervention achieved significant reductions in albumin use and cost savings without changes in patient outcomes, supporting the combination of financial and nonfinancial strategies to align providers with evidence-based practices.
AHRQ-funded; HS000055.
Citation: Lyu PF, Hockenberry JM, Gaydos LM .
Impact of a sequential intervention on albumin utilization in critical care.
Crit Care Med 2016 Jul;44(7):1307-13. doi: 10.1097/ccm.0000000000001638.
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Keywords: Critical Care, Healthcare Utilization, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Practice Patterns
Silverberg JI
Practice gaps in pruritus.
There are several practice gaps in the evaluation and management of itch. These gaps include a dearth of objective measures of itch, infrequent use of validated patient-reported outcomes for itch, non-evidence-based treatment, and lack of consensus about the ideal workup for generalized itch. The present article reviews these gaps and presents potential solutions.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Practice gaps in pruritus.
Dermatol Clin 2016 Jul;34(3):257-61. doi: 10.1016/j.det.2016.02.008.
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Keywords: Care Management, Evidence-Based Practice, Patient-Centered Outcomes Research
Cohen DJ, Balasubramanian BA, Gordon L
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness.
AHRQ-funded; HS022981; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Gordon L .
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
Implement Sci 2016 Jun 29;11(1):86. doi: 10.1186/s13012-016-0449-8.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Research Methodologies
Huang ES
Management of diabetes mellitus in older people with comorbidities.
Guidelines recommend that physicians individualize the intensity of glucose control and treatments on the basis of the prognosis (for example, three tiers based on comorbidities and functional impairments). Very few studies have attempted to study these concepts in clinical practice. To better meet the treatment needs of older patients with diabetes and comorbidities, more research is needed to determine the risks and benefits of intensifying, maintaining, or de-intensifying treatments in this population.
AHRQ-funded; HS018542.
Citation: Huang ES .
Management of diabetes mellitus in older people with comorbidities.
BMJ 2016 Jun 15;353:i2200. doi: 10.1136/bmj.i2200.
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Keywords: Diabetes, Elderly, Patient-Centered Outcomes Research, Chronic Conditions
Kaplan HC, Sherman SN, Cleveland C
Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.
The objective of this study was to understand conditions that enable delivery of antenatal corticosteroid administration (ANCS) with high reliability among hospitals participating in an Ohio Perinatal Quality Collaborative (OPQC) ANCS project. Among the major themes supporting reliable implementation of ANCS at these hospitals that emerged were: (1) presence of a high reliability culture, (2) processes that emphasize high reliability, and (3) timely and efficient administration process.
AHRQ-funded; HS021114.
Citation: Kaplan HC, Sherman SN, Cleveland C .
Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.
BMJ Qual Saf 2016 Jun 8;25(3):173-81. doi: 10.1136/bmjqs-2015-003984..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Maternal Care
Ridner SH, Rhoten BA, Radina ME
Breast cancer survivors' perspectives of critical lymphedema self-care support needs.
The purpose of this paper was to solicit breast cancer survivors' perspectives on the variety of issues they face related to lymphedema self-care and to identify support needs perceived as critical for managing their chronic medical condition. The authors found that lack of support and the failure of others to recognize lymphedema as a chronic condition set this patient population apart from other patients with chronic diseases and decreases the amount of help needed to manage the condition.
AHRQ-funded; HS022990.
Citation: Ridner SH, Rhoten BA, Radina ME .
Breast cancer survivors' perspectives of critical lymphedema self-care support needs.
Support Care Cancer 2016 Jun;24(6):2743-50. doi: 10.1007/s00520-016-3089-2.
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Keywords: Cancer: Breast Cancer, Chronic Conditions, Patient-Centered Outcomes Research, Patient Self-Management
Khazanie P, Greiner MA, Al-Khatib SM
Comparative effectiveness of cardiac resynchronization therapy among patients with heart failure and atrial fibrillation: Findings from the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.
The researchers investigated the outcomes of patients with both atrial fibrillation and heart failure who receive cardiac resynchronization therapy with defibrillator (CRT-D) compared with an implantable cardioverter-defibrillator (ICD) alone. They found that CRT-D was associated with lower risks of mortality, all-cause readmission, and heart failure readmission, as well as with a similar risk of complications compared with ICD alone.
AHRQ-funded; HS021092.
Citation: Khazanie P, Greiner MA, Al-Khatib SM .
Comparative effectiveness of cardiac resynchronization therapy among patients with heart failure and atrial fibrillation: Findings from the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.
Circ Heart Fail 2016 Jun;9(6). doi: 10.1161/circheartfailure.115.002324.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Registries, Evidence-Based Practice, Outcomes
Hochman MJ, Wolf S, Zafar SY
Comparing unmet needs to optimize quality: characterizing inpatient and outpatient palliative care populations.
The researchers compared the unmet needs of palliative care patients by location of care to better characterize these populations. They found that outpatients are more burdened by pain at first palliative care encounter compared to inpatients, yet outpatients experience higher quality of life and better performance status.
AHRQ-funded; HS023681.
Citation: Hochman MJ, Wolf S, Zafar SY .
Comparing unmet needs to optimize quality: characterizing inpatient and outpatient palliative care populations.
J Pain Symptom Manage 2016 Jun;51(6):1033-39.e3. doi: 10.1016/j.jpainsymman.2015.12.338.
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Keywords: Quality of Care, Inpatient Care, Ambulatory Care and Surgery, Palliative Care, Patient-Centered Outcomes Research
Kostick KM, Minard CG, Wilhelms LA
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
The authors presented a comprehensive and valid methodology for developing a clinically informed and patient-centered measure of knowledge about left ventricular assist device (LVAD) therapy to facilitate discussion and measure candidate understanding of treatment options. They concluded that the LVAD knowledge scale may be useful in clinical settings to identify gaps in knowledge among patient candidates considering LVAD treatment; to better tailor education and discussion with patients and their caregivers; and to enhance informed decision-making before treatment decisions are made.
AHRQ-funded; HS024849.
Citation: Kostick KM, Minard CG, Wilhelms LA .
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
J Heart Lung Transplant 2016 Jun;35(6):768-76. doi: 10.1016/j.healun.2016.01.015.
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Keywords: Shared Decision Making, Heart Disease and Health, Medical Devices, Patient and Family Engagement, Patient-Centered Outcomes Research
Peek ME, Lopez FY, Williams HS
Development of a conceptual framework for understanding shared decision making among African-American LGBT patients and their clinicians.
The purpose of this review was to understand how race, sexual orientation and gender identity can simultaneously influence shared decision making (SDM) among African-American LGBT persons. It also presents a conceptual model for understanding SDM in African-American LGBT persons, wherein multiple systems of social stratification (e.g., race, gender, sexual orientation) influence patient and provider perceptions, behaviors, and shared decision making.
AHRQ-funded; HS023050.
Citation: Peek ME, Lopez FY, Williams HS .
Development of a conceptual framework for understanding shared decision making among African-American LGBT patients and their clinicians.
J Gen Intern Med 2016 Jun;31(6):677-87. doi: 10.1007/s11606-016-3616-3.
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Keywords: Shared Decision Making, Social Determinants of Health, Racial and Ethnic Minorities, Patient-Centered Outcomes Research
Piccini JP, Simon DN, Steinberg BA
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
The purpose of this paper was to determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with atrial fibrillation (AF). The authors found that women with AF have more symptoms and worse quality of life, lower risk-adjusted all-cause and cardiovascular death compared with men, but higher stroke rates.
AHRQ-funded; HS021092.
Citation: Piccini JP, Simon DN, Steinberg BA .
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
JAMA Cardiol 2016 Jun 1;1(3):282-91. doi: 10.1001/jamacardio.2016.0529.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Registries, Evidence-Based Practice
Roberts ET, DuGoff EH, Heins SE
Evaluating clinical practice guidelines based on their association with return to work in administrative claims data.
The researchers examined the association between non-adherence to clinical practice guidelines (CPGs) and time to return to work (RTW) for patients with workplace injuries. They found that early receipt of care and getting less than the recommended amount of care were correlated with faster RTW, while excessive physical therapy, bracing, and injections were associated with slower RTW. They recommended that CPGs supported by observational studies or randomized trials may have a more certain relationship to health outcomes.
AHRQ-funded; HS000029.
Citation: Roberts ET, DuGoff EH, Heins SE .
Evaluating clinical practice guidelines based on their association with return to work in administrative claims data.
Health Serv Res 2016 Jun;51(3):953-80. doi: 10.1111/1475-6773.12360.
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Keywords: Guidelines, Injuries and Wounds, Patient-Centered Outcomes Research
Heerman WJ, Wallston KA, Osborn CY
Food insecurity is associated with diabetes self-care behaviours and glycaemic control.
The objective of the study was to examine the association between food insecurity, diabetes self-care and glycaemic control. It concluded that there was a high rate of food insecurity in a sample of patients with Type 2 diabetes who were of low socio-economic status. Food insecurity was associated with less adherence to recommended self-care behaviours and worse glycaemic control.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Wallston KA, Osborn CY .
Food insecurity is associated with diabetes self-care behaviours and glycaemic control.
Diabet Med 2016 Jun;33(6):844-50. doi: 10.1111/dme.12896.
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Keywords: Diabetes, Nutrition, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Patient Self-Management
Naidech AM, Polnaszek KL, Berman MD
Hematoma locations predicting delirium symptoms after intracerebral hemorrhage.
The researchers tested the hypothesis that hematoma location is predictive of delirium symptoms in patients with intracerebral hemorrhage. Identifying 90 patients with intracerebral hemorrhage, they found that acute delirium symptoms were predicted by hematoma of right-hemisphere subcortical white matter and parahippocampal gyrus. The authors concluded that disruption of large-scale brain networks that normally support attention and conscious awareness was thus associated with acute delirium symptoms.
AHRQ-funded; HS023437.
Citation: Naidech AM, Polnaszek KL, Berman MD .
Hematoma locations predicting delirium symptoms after intracerebral hemorrhage.
Neurocrit Care 2016 Jun;24(3):397-403. doi: 10.1007/s12028-015-0210-1.
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Keywords: Neurological Disorders, Patient-Centered Outcomes Research, Quality of Life
Chin MH, Lopez FY, Nathan AG
Improving shared decision making with LGBT racial and ethnic minority patients.
In 2014, the authors' team at the University of Chicago, supported by funds from AHRQ and the Patient-Centered Outcomes Research Trust Fund, began examining how to reduce disparities for LGBT racial/ethnic minority patients through improved shared decisionmaking (SDM). Their three goals are to review what is known, to perform interviews and focus groups of patients and clinicians, and to develop tools and resources. The three articles in this issue’s JGIM symposium on "Improving Shared Decision Making with LGBT Racial and Ethnic Minority Patients" reflect their initial foundational work.
AHRQ-funded; HS023050.
Citation: Chin MH, Lopez FY, Nathan AG .
Improving shared decision making with LGBT racial and ethnic minority patients.
J Gen Intern Med 2016 Jun;31(6):591-3. doi: 10.1007/s11606-016-3607-4.
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Keywords: Shared Decision Making, Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Osborn CY, Mayberry LS, Kim JM
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
The authors sought to identify which behaviors are most important for HbA1c among low-socioeconomic status patients with type 2 diabetes mellitus. They found that only medication adherence was significantly associated with lower HbA1c after adjusting for the other self-care behaviours and further adjusting for demographic and diabetes characteristics. They suggested that focused efforts to improve medication adherence among low-socioeconomic status patient populations may improve glycemic control.
AHRQ-funded; HS022990.
Citation: Osborn CY, Mayberry LS, Kim JM .
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
J Clin Pharm Ther 2016 Jun;41(3):256-9. doi: 10.1111/jcpt.12360.
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Keywords: Diabetes, Low-Income, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Ehrlich SF, Sternfeld B, Krefman AE
Moderate and vigorous intensity exercise during pregnancy and gestational weight gain in women with gestational diabetes.
The researchers estimated the associations of exercise intensity during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery. Upon stratification by prepregnancy overweight/obesity, they found that significant associations were only observed for BMI greater than or equal to 25.0. There were no associations observed for moderate intensity exercise.
AHRQ-funded; HS019367.
Citation: Ehrlich SF, Sternfeld B, Krefman AE .
Moderate and vigorous intensity exercise during pregnancy and gestational weight gain in women with gestational diabetes.
Matern Child Health J 2016 Jun;20(6):1247-57. doi: 10.1007/s10995-016-1926-z.
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Keywords: Diabetes, Lifestyle Changes, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research, Pregnancy, Women
Desai RJ, Glynn RJ, Wang S
Performance of disease risk score matching in nested case-control studies: a simulation study.
The authors investigate whether or not matching on a disease risk score (DRS), which includes many confounders, results in greater precision than matching on only a few confounders. Their results suggest that DRS matching might increase the statistical efficiency of case-control studies, particularly when the outcome is rare.
AHRQ-funded; HS022193.
Citation: Desai RJ, Glynn RJ, Wang S .
Performance of disease risk score matching in nested case-control studies: a simulation study.
Am J Epidemiol 2016 May 15;183(10):949-57. doi: 10.1093/aje/kwv269.
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Keywords: Research Methodologies, Risk, Patient-Centered Outcomes Research